Correction of craniodorsal coxofemoral luxation in cats and small breed dogs using a modified Knowles technique with the braided polyblend TightRope™ systems

Abstract

Clinical use of the Arthrex Mini TightRope and TightRope systems can be recommended for traumatic craniodorsal coxofemoral luxation in this novel application as short-term results are at least comparable to existing surgical techniques. Long-term follow-up studies are needed.

The Treatment of Coxofemoral Luxation by Modified Synthetic Capsule Technique in Dogs: 6 Cases

“…The reduction with Toggle pin can be disrupted by suture breaking between femoral head and acetabulum [29,32] . In a study, traumatic craniodorsal coxofemoral luxations in cats and small dogs were treated successfully by using using a modified Knowles technique, but mean weight of included dogs in this study was 15 kg [16] . In another study which compared toggle rod and suture anchor, it was reported that toggle rod constructs failed primarily by breakage of the suture at the rod eyelet and suture anchor constructs failed when the anchors pulled through the medial acetabular wall [17] .…”

“…The luxation should be treated surgically; if there are complications such as hip dysplasia existence prior to trauma, femoral and/or acetabular avulsion fractures, intra articular fractures, arthrosis and conditions such as multiple orthopedic injuries or chronic luxation, closed reduction failure and extreme instability after reduction [5,8,12,13] . Techniques which are used for the surgical treatment of coxofemoral luxations can be categorized as extracapsular such as suture of a joint capsule (capsulorrhaphy) [3,5,12] , synthetic capsule technique [2,3,6,14] , transposition of the greater trochanter [2,5,6,12] , triple pelvic osteotomy [2,8] and intra capsular techniques such as Modified Knowles Toggle pin fixation [3,6,8,15,16] , Toggle rod stabilization [17,18] , trans acetabular pinning [2,6,19] transposition of the sacrotuberous ligament [20,21] . Additionally, flexible external fixation [8] , total hip replacement [22][23][24] and femoral head and neck osteotomy [2,25,26] can be also applied for the treatment of hip luxation.…”

Mechanical analysis of suture attachment methods in toggle suture constructs

“…Craniodorsal luxation is the most common luxation type diagnosed, occurring in 79% of luxations . Several techniques have been described to address coxofemoral luxation in the dog . No single method of luxation repair has proved to be superior in terms of outcome.…”

“…No single method of luxation repair has proved to be superior in terms of outcome. Short and long term reluxation rates for open reduction range from 0% to 28% …”

“…Stabilization of a coxofemoral luxation with a toggle suture construct is one of the more common surgical methods used for hip luxation repair and has a success rate of 86%‐89% . Among cases that fail, the most common reported complication after reduction and stabilization with a toggle rod is breakage of the suture and reluxation of the coxofemoral joint . Analysis shows that construct failure typically occurs in 1 of 3 ways: toggle deformation, suture breakage away from the toggle and most commonly, suture breakage at the toggle–suture interface …”